﻿<!-- saved from url=(0061)http://dp.sina.cn/dpool/tools/bus/index2.php?city=0791&pos=63 -->
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	href="http://u1.sinaimg.cn/3g/image/upload/0/110/176/19509/64477c90.png">

<title>美的空气净化器VIP预约提货</title>

<link href="/file_input/style.css" rel="stylesheet" type="text/css">
<link rel="stylesheet" type="text/css" href="/file_input/common.min.css">
<link rel="stylesheet" type="text/css" href="/file_input/skin.css">
<script type="text/javascript" src="/file_input/jquery.js"></script>
<script src="/js/jquery-1.7.min.js" type="text/javascript"></script>
<script type="text/javascript">
	window.onload = init;

	function init() {

		var w = document.body.clientWidth;
		$(".txt_input").width((w-130)+"px").css("border", "0");
		$("textarea").width((w-130)+"px").css("border","0");
		var h =  (1080/640)* w;
		$(".dback").width(w+"px");
		$(".dback").height(h+"px");
		
		$(".l-c-cont").height(700*(h/1080)).css("padding-top",288*(h/1080));
		
		$(".bt_center").width(100).css("margin-left",
				(w / 2 - 51) + "px");
		var provs=new Array(
				"请选择",
				"江西省",
				"广东省",
				"福建省",
				"上海市",
				"浙江省",
				"江苏省",
				"海南省",
				"湖南省",
				"湖北省",
				"安徽省",
				"广西自治区",
				"贵州省",
				"云南省",
				"西藏自治区",
				"四川省",
				"重庆市",
				"新疆自治区",
				"陕西省",
				"甘肃省",
				"青海省",
				"宁夏自治区",
				"内蒙古自治区",
				"山西省",
				"河北省",
				"河南省",
				"山东省",
				"天津市",
				"北京市",
				"辽宁省",
				"吉林省",
				"黑龙江省");	
		$.each(provs,function(index,val){
			if(index==0){
				$("#seachprov").append("<option selected>"+val+"</option>");
			}else{
				$("#seachprov").append("<option>"+val+"</option>");
			}
		});

	};

	function check() { 
		var regC = /[^ -~]+/g; 
		var regE = /\D+/g; 
		var str = t1.value; 
		if (regC.test(str)){ 
		    t1.value = t1.value.substr(0,50); 
		} 
		if(regE.test(str)){ 
		    t1.value = t1.value.substr(0,100); 
		} 
	}
	function submitform() {
		if (document.myform.cardno.value == ""
				|| document.myform.password.value == ""
				|| document.myform.name.value == ""
				|| document.myform.phoneno.value == ""
				|| document.myform.confirmphoneno.value == ""
				|| document.myform.seachprov.value == "请选择"
				|| document.myform.detail.value == "") {
			alert("信息不完整！");
			return false;
			
		}else if(document.myform.phoneno.value!=document.myform.confirmphoneno.value){
			alert("手机号不一致！");
			return false;
		}else{

			var options_prov=$("#seachprov option:selected"); 
			document.forms["myform"].action="/weixin/submit";
			return true;
		}
	}

</script>

	<style type="text/css">
		
		.dback{
			background-image:url('/weixinimages/backinput.gif');
			background-repeat:no-repeat;
			background-position:center;
			border: 1px solid black;
			-webkit-background-size: cover;
			-moz-background-size: cover;
			-o-background-size: cover;
			background-size: cover;
			height: 1080px;
			width: 640px;
		}
		
		.dback ul{
			border:1px solid #ccaa33;
			color: rgb(102,43,0);
			margin: 1px;
		}
		textarea{
			height:50px;
		}
	</style>


</head>
<body >
<div class="dback">
	<div class="l-c-cont">
		<div class="query-box qb-t2">
			<form name="myform" onsubmit="return submitform();" method="post">

				<ul>
					<li><span style="text-align:right"><img
							src="/images/mustinput.png" width="7px" height="7px" >卡号：</span><input
						type="text" maxlength="15" class="txt_input" name="cardno" /></li>
				</ul>

				<ul>
					<li>
							<span style="text-align:right"><img src="/images/mustinput.png" width="7px" height="7px" maxlength="15">密码：</span>
							<input	type="text" class="txt_input" maxlength="15" name="password" />
					</li>
				</ul>

				<ul>
					<li><span style="text-align:right"><img
							src="/images/mustinput.png" width="7px" height="7px" >收货人：</span><input
						type="text" class="txt_input" maxlength="30" name="name" /></li>
				</ul>

				<ul>
					<li>
						<span style="text-align:right"><img
							src="/images/mustinput.png" width="7px" height="7px" >手机：</span><input
						type="text"  maxlength="11" class="txt_input" name="phoneno" /></li>
				</ul>
				
				<ul>
					<li>
						<span style="text-align:right"><img
							src="/images/mustinput.png" width="7px" height="7px" >确认手机：</span><input
						type="text"  maxlength="11" class="txt_input" name="confirmphoneno" /></li>
				</ul>

				<ul>
					<li><span style="text-align:right"><img	src="/images/mustinput.png" width="7px" height="7px">省份：</span>
							<select style="background:transparent;"  id="seachprov" name="seachprov" class="txt_input" ></select>
					</li>
				</ul>
			    
				<ul style="height:55px">
				<li>
					<span
						style="text-align:right;height:50px;"><img src="/images/mustinput.png" width="7px" height="7px" maxlenth="100">详细地址：</span>
						<textarea style="background:transparent;" placeholder="请填入您的详细收货地址" maxlength="100"  onkeyup="check()" name="detail" ></textarea></li>
				
				</ul>
				<ul style="height: 55px">
					<li><span style="text-align:right;height:50px;">备注：</span> <textarea
							style="background:transparent;" maxlength="100" onkeyup="check()" name="comment" ></textarea></li>
				</ul>

				<ul class="bt_center" style="margin: 0px;margin-top:20px">
					<li><input type="submit" value="提交" style="text-align: center;width: 100%;margin: 0;color: rgb(102,43,0);" ></li>
				</ul>

			</form>
		</div>
	</div>
</div>



</body>
</html>